Well, its been a while since I've had a chance to put any updates together. The girls were born almost
2 weeks ago, but there really hasn't been anything to share. I have started several posts, all of them are now collecting dust in the "drafts" bin. Just haven't had enough time to really sit down and get my thoughts together and I have no desire to bore you with the daily, "well Zoey gained 32 grams, took 40ml of feeds, and spit up 4ml" details. And honestly, that is about all the information I could have given you anyway. As I said from the get go, the girls are doing great, its just a matter of putting on weight.
The one question everyone has been asking, "when do they get to come home" has been anyone's guess and question I have been avoiding. We learned about 2/3rd's of the way through the pregnancy that it is dangerous to be making guesses and setting expectations. Its impossible to predict how any of this will go and when it doesn't go the way you had expected, its heartbreaking... and it WILL be heart breaking. This hard fact reared its ugly head two weeks ago. After having a near text book pregnancy we found out from our last ultrasound that the girls weren't growing fast enough, would have to come much earlier than we had expected, and were probably going to need to spend a considerable (which we considered more than a day or two) amount of time in the NICU. This was a trying period of uncertainty for Teri and I, I didn't want to put any of that weight on anyone else. The girls are doing great, they will be home when they are ready.... That is all you are going to get from me.
There have always been four checkpoints on the wall that needed to happen before we could bring them home. The first is to be taking all of their feeds from a nipple for 3 days. They each got minimum feed requirements, Zoey took her first feed shortly after birth and she met her requirements. Nikki was initially put on a breathing mask to help inflate her lungs and clear out fluids. Because of this Nikki was unable to eat from a nipple, she had to have her food delivered through a feeding tube. Zoey's eating only lasted a few days. As is typical at her premature size, she just started getting tired during her feeding and would only take about half, if that, of what she should. Both Zoey and Nikki spent several days getting fed via tube inserted in their nose. As expected though it didn't take long. They have been feeding exclusively from a nipple for about 5 days now and both of them got their feeding tubes removed 3 days ago. Item 1, check.
The second requirement is to have no "episodes" for 5 days. The girls are hooked up to respiratory and heart monitors 24/7. Typically the brain isn't developed enough to regulate its own breathing and inherently, their heart rate, on its own until about 34 weeks gestation. With premature babies it isn't uncommon for them to almost literally "forget" to breathe. This causes a dip in heart rate and can be dangerous. Most of the time, all they really need is a little pinch or tickle from a nurse to wake them up where as they remember to start breathing again. Any time their heart rates drop to below 80 beats per minute, alarms start going off. The nurses will give them a second or two for it to recover on their own, but if they don't and they need to intervene they count it as an "episode" and the 5 day counter resets to 0. The girls had another set of twins rooming with them. One of them was all ready to go home that day, their parents were coming to pick her up in a few hours.... while we were sitting there, the alarms went off and an episode was logged. I'm just glad I wasn't there to hear the nurse tell them when they arrived that it was going to be another 5 days. Incidentally, the other twin, being a few days from going home, also had an episode the next day. The good news for us is that neither girl ever logged an episode in the time we were there. There were a few brief alarms, but never long enough that anyone had any concern. Item 2, check.
The third requirement is that they have to be able to maintain their own body heat. From the time they were born they were placed in isolates to incubate them. Initially, they were kept at 30 deg C and they remained there for about a week. Once they were comfortable with how they were growing, they began lowering the temp by .5 degree every 12 hours and continuing to monitor their body temps. We did pretty well with that making it down to the minimum of 27 deg C in about 4 days. A few days ago they were moved to open air cribs being entirely self sufficient and have both been doing great since. Item 2, check.
The fourth requirement is that their weight has to be trending upward and they want them above 1800 grams in weight (4 lbs). They were both born at about 3lb 14 oz, 2 oz shy of the 1800 grams. As with all babies they lost about 8% of their body weight in the first week taking them both down to about 1650 grams. These past 6 days as been a trend back towards the top. As of today, Zoey was up to 1792 and Nikki was at 1756.
With all of that said, there is enough information
available that I am confident enough to let everyone know a time frame
of when that day will be. The doctors have pretty much checked off #4. They said that they have been eating so well, and taking such a good volume that there is no reason to keep them any longer. They want to see how things go the next 12 hours, pending anything unexpected, they will be coming home tomorrow.
So here we are.... after having been hoping for no days in the NICU, to 2-3 days... to a week.... .we finally have some solid assurance that the day is here. Ryley is absolutely ecstatic and both Teri and I are really looking forward to settling into a routine, no matter how chaotic it may be.
Time to enjoy that last few consecutive hours of silence this house will see for a long time.
